Pediatric Annals Editor-in-Chief Stanford T. Shulman, MD, is the Virginia H. Rogers Professor of Pediatric Infectious Diseases at Northwestern University Feinberg School of Medicine; and Chief of the Division of Infectious Disease at the Ann and Robert H. Lurie Children’s Hospital, Chicago, IL.
Dr. Shulman is the recipient of the AAP 2011 Award for Lifetime Contribution to Infectious Disease Education.
An avid stamp collector, Dr. Shulman chooses relevant stamps from his personal collection to accompany his column each month.
Reach Dr. Shulman via email:
Perspective, or any of its synonyms, such as “viewpoint,” “mindset,” or “frame of reference,” can be a refreshing way to look at or think about a concept or idea or circumstance. We pediatricians generally should take into account the older child’s perspective related to an illness when feasible. Sydney Speed, a 12-year-old female patient of Andrew A. Bremer, MD, PhD, a member of the Pediatric Annals editorial board, brought the following perspective to him on a diabetes clinic visit, and with her permission he has forwarded it to us. I have decided to publish it here exactly as Sydney wrote it, as it’s quite remarkable, and I want to share it with the readership.
Diabetes: A Child’s Perspective
Diabetes. Dictionary.com defines it as, “Also called type 1 diabetes, insulin-dependent diabetes, juvenile diabetes. a severe form of diabetes mellitus in which insulin production by the beta cells of the pancreasis impaired, usually resulting in dependence on externally administered insulin, the onset of the disease typically occurring before the age of 25 [years].” Most common people would define it as, “a terrible, life-long condition that stinks.” I define it as a lifestyle that doesn’t make you any different from anybody else. It doesn’t make you less normal or more different. And yet, in spite of all of the negative comments and reputations type 1 diabetes gets, I define it as a blessing. In some cases it helps make you who you are. In other cases, such as mine, it gives you goals, dreams, and ambitions in life.
Having type 1 diabetes doesn’t make you any different than anyone else and it doesn’t hold you back from anything. Five years ago, at the age of 7, I was diagnosed with it, so I know this from experience. During the summer, sweat drips off my body from swimming, boating, tubing, bike riding, running, playing outside, climbing trees, riding 4-wheelers and dirt-bikes, and hanging out with friends. During the winter I can’t resist sledding and playing in the snow. I play basketball and volleyball year round. I spend the night at friends’ houses, and I babysit. I study hard to keep my straight “A” report card and for academic team meets. I am also on my school’s student council. I travel to many different places. I can even eat sugar! It has never held me back from anything. It never will. It has never made me any different from any of my friends or family. It never will. When I look in the mirror, I don’t see a held-back diabetic girl, I see a normal girl smiling back at me.
Sometimes type 1 diabetes can help make you who you are. When I first found out I had it, I was scared and devastated. I was afraid I wouldn’t be able to do the normal things I always do, such as hang out with my friends. When I kept doing the normal things I have always done and kept being successful with diabetes, it made me more confident. Making it through everything with it, such as sports, illnesses, successes, and day-to-day activities, has helped me to realize that I can do anything. It has also made me more responsible. Every day I have to remember to check my blood glucose before I eat, calculate the amount of carbohydrates my food contained, and take my insulin after I eat. Being responsible while doing these things has made me more responsible in everything I do. Having diabetes has also helped me to realize how blessed I am. I know, I know, it sounds crazy. But it’s true. Having diabetes has made me feel so blessed because it’s only diabetes. No matter how bad my situation is, it could always be worse. I am blessed to only have diabetes as my overall “problem” in life. Finally, diabetes is also a blessing in some cases, such as mine, because it gives me ambitions, dreams, and goals in life. It has helped me to form my main ambition or goal, which is to be a pediatric endocrinologist when I grow up. A pediatric endocrinologist is a children’s diabetes doctor. I want to do this so I can help kids with diabetes thrive with it and feel like I do about it. It has also given me the dream of going to Vanderbilt University for medical school. Before I got diabetes I had no idea what I wanted to be when I grew up or where I wanted to go to college. Having diabetes has helped me figure out the answer to these questions that adults always ask kids.
Diabetes is like a pit bull. It gets a bad reputation that it doesn’t always deserve. Having diabetes doesn’t make you any different than anyone else. In fact, it makes you extraordinary. With diabetes, I do all the normal things that all my family and friends do. It never holds me back and never will. It has helped shape me into who I am today and it has helped me sculpt who I want to be when I’m an adult. So for now, my pit bull and I will carry on with our lives the normal, yet extraordinary way and I will always see a fantastic girl smiling back at me in every mirror.
This essay is quite remarkable for its strength and optimism and should urge us all to listen to our patients’ perspectives on their illnesses or circumstances whenever we can.
Stamp issued by Bangladesh in 2011 to celebrate 30 years of open heart surgery at the National Institute of Cardiovascular Diseases in Dhaka.
This Month’s Stamps
The blue stamp shown here was issued by Bangladesh in 2011 to celebrate 30 years of open heart surgery at the National Institute of Cardiovascular Diseases in Dhaka. Portrayed at the top left is a heart with a cannula taking bluish blood to a bypass circuit and another returning red blood to the heart.
The block of 8 stamps was issued by Brazil, also in 2011, and as we’ve seen in other countries, particularly African ones, it demonstrates how governments are using stamps to promote public health, in this case, to educate Brazilians about AIDS.
The messages run the gamut from abstinence to condom use, and even to the celebration of pharmacological enhancements (“Hurray for the blue pill [Viagra] and hurray for me!” is the message from the stamp in the top right corner, depicting a condom).
A block of 8 stamps issued by Brazil in 2011 to promote education about AIDS.Images courtesy of Stanford T Shulman, MD.
The second row of stamps can be translated as, saying “Single use” for syringes, and “You can’t get AIDS from the air.” In the third row, the first stamp indicates that when no condom is available, abstinence is best: “When you should wait for tomorrow.” That is followed by the message that “three’s a crowd in a relationship,” and so AIDS should be “left out.” In the bottom row the messages are, “Hurray for AIDS solidarity,” and lastly, “…And they lived happily ever after.”